Diagnostic Accuracy of Blood-based Biomarkers for Pancreatic Cancer: A Systematic Review and Meta-analysis.

Unlabelled: Pancreatic ductal adenocarcinoma (PDAC) has a 5-year survival rate below 5%. Carbohydrate antigen 19-9 (CA19-9) is the most commonly used blood-based biomarker for PDAC in current clinical practice, despite having been shown repeatedly to be inaccurate and have poor diagnostic performance. This review aims to assess the reported diagnostic accuracy of all blood-based biomarkers investigated to date in PDAC, by directly comparing individual biomarkers and multi-biomarker panels, both containing CA19-9 and not (novel).

Flaubert's Madame Bovary: a study in envy and revenge.

Flaubert's Emma Bovary is one of the most convincingly realized characters in modern literature. Her husband, Charles, a rural doctor, loves her dearly, but he is dull, ineffectual, and boring. Emma seems to hate him with a fury that knows no bounds.

The concept of psychic reality--how useful?

The author argues that Freud coined the phrase 'psychic reality' to indicate how neurotic patients and others treat unconscious psychic concepts and fears as if they were real. They respond to the challenges of everyday life not in terms of objective reality, but rather in keeping with their inner 'psychic' reality. With the development of different schools of thought in psychoanalysis, opinions as to precisely what constitutes the contents and character of unconscious mental functioning differ enormously, to the extent that there is no general agreement as to the nature and quality of unconscious mental elements.